I still remember taking my first Wilderness First Aid course from the Red Cross. At the time I thought it was great, it helped me land my first summer-camp counselor job. After I certified as an EMT and Wilderness EMT, I quickly learned that I knew just enough to be dangerous.
Over time I realized that many hikers I met on the trail didn’t know the first thing about self-care in the woods, let alone basic emergency medical practices.
By far the biggest basic-level mistake hikers are making in first aid care, is not knowing how to use the emergency kit they are carrying.
It’s easy to grab a hiking first aid kit off Amazon, throw it in your backpack, and never double check what’s in it. I’m going to help you learn what to put in your backpacking first aid kit, which med kits are worth your time, and point out a few pro tips you can use in the field.
Let’s get right into picking out the best emergency kits for your hiking backpack!
What You'll Learn
- Best Hiking First Aid Kits: Reviewed
- What Should Be In a First Aid Kit for Hiking?
- What Medical Conditions Am I Likely to Encounter?
- Survival Kit vs First Aid Kits
- Building the Perfect Hiking First Aid Kit
- Knowing When to Call for Help
Best Hiking First Aid Kits: Reviewed
- Contents cover the majority of simple situations
- Minimal unnecessary contents
- Small & lightweight
This mini first aid kit avoids going bananas on items and keeps the price, weight, and size to a minimum – while still covering basic outdoor needs.
I’d ditch the nearly-useless carabiner and whistle, as they don’t belong in a med kit.
Everything else has a place. Add some antibiotic ointment and mole foam to supplement the blister treatments, and you’ll be close to ready.
Note that this kit is missing medicines such as ibuprofen and other basic generic drugs. Be sure to add these before hitting the trail.
Best for: a baseline starting kit for hiking that doesn’t go overboard on supplies.
If you’d prefer something more robust to take care of your prebuilt medical kit needs on the trail, here you go.
- Lots of medications
- Lots of bandages
- Heavier and bulkier than some
In this kit, you’ll have generic drugs like ibuprofen, aspirin, and non-aspirin tablets. You’ll also get more specialty items like finger splints, emergency blankets, and more.
The reason this kit doesn’t take first place is I think it’s a little too “broad”. The number of times you need a thermometer in the backcountry is rare, and things like emergency aluminized blankets belong more in survival kits than as first aid essentials.
That said, being prepared is never a bad thing and all of these meds, supplies, and tools are useful in certain medical situations. For minor injuries, this should have you covered.
Best for really covering your bases – but be sure to mix and match with personal additions.
- Precut moleskin
- Irrigation syringe
- Wilderness medicine handbook
In the pressure of an emergency, you might not be able to look at the book, but it’s helpful when you’re sitting around wondering what to do about the weird-looking open wound on your leg…
Irrigation syringes are nice for cleaning wounds or abrasions, and it’s good to see one included here. However, despite all the good contents of this kit it still lacks personalization.
It’s a happy middle ground between the more minimalist first kit we reviewed and the more comprehensive second one.
I’d mark this as the best kit for educated wilderness medicine practitioners to start with for modification.
What Should Be In a First Aid Kit for Hiking?
Learning What to Take
Figuring out what should go in your hiking first aid kit and what should stay at home can be daunting, particularly if you lack experience. I’m going to suggest the best way to actually determine what does in your hiking first aid kit is to get certified.
Reading articles (like this one) and watching YouTube, can only take you so far. Hands-on training builds critical judgment and skills that you’ll lack from other learning sources.
Education can help you determine with clarity what to bring and what to leave behind – and crucially, how to use it.
Wilderness Medicine Certifications
Without a doubt, one of the biggest returns on investment for any outdoor enthusiast is a wilderness medicine course of some kind. You don’t need to be a doctor or even in the medical field – these courses are made for, and made to benefit the “average joe”.
In order of depth of knowledge the certifications you’d most likely want to achieve would be:
- Wilderness First Aid
- Wilderness First Responder
- Wilderness EMT
Most recreational hikers will benefit from the WFA course. It’s inexpensive, takes little time, and teaches practical skills you’re likely to remember – and be able to use – in an emergency. I think anyone hitting the trail regularly should get this training.
If you’re a professional outdoor guide, fishing guide, or other outdoor worker, you might consider getting your WFR certification. This is a more expensive cert that deep-dives into the details of wilderness medical emergencies and how to treat them. WFR must be maintained every 2 years and requires a financial and time commitment.
For high-level outdoor guides, or those working on wilderness search and rescue teams a WEMT (or better) certification is needed. This cert is higher than most people need – even most outdoor guides don’t need it. It’s very expensive and time-consuming but the education and understanding is unmatched.
After you go through a little hands-on training you’re much more likely to understand what medical tools and supplies are worth having with you, and which ones to leave at home.
The Wilderness Medicine Institute of NOLS and Stonehearth Open Learning Center are the only wilderness medicine schools I am familiar enough with to recommend. These schools are widely accepted as industry-leaders by professional outdoor guides.
What Medical Conditions Am I Likely to Encounter?
I’m not going to give you a dissertation on wilderness injuries and illnesses. What I will do, is break it down real quick with info you can use to choose the right first aid kit for you.
The contents of your first aid kit should be based on what you’re most likely to deal with in the wilderness, right?
Here’s what that looks like:
Illnesses on the trail
As you can see from the chart, nausea, vomiting, and diarrhea are the biggest culprits of illness on the trail. Outside of that, the causes are scattered and hard to make sense of. With the exception – maybe – of allergies.
What you should take away from this is that your medical kit needs to be able to handle NVD illnesses. Medicines such as Tums or Pepto Bismol are helpful for minor upsets.
When severe NVD sets in, be prepared to deal with dehydration. Powdered electrolyte mix in your med kit isn’t a bad idea.
Unfortunately, NVD is often caused by an infection or illness due to poor trail hygiene and cooking. You may have to get off the trail and see a doctor for antibiotics.
Wash your hands often and clean your cooking utensils thoroughly to reduce exposure to NVD illnesses.
First Aid for Hiking Injuries
Athletic injuries and soft tissue injuries make up almost 80% of all injuries on the trail recorded by this study.
Injuries include sprains and strains, cuts, scrapes, bruises, and blisters. In my experience, – both personally and while guiding backpacking trips – I know this to be true.
Blisters are by far the most common medical problem on the trail. Fortunately, you can use many of the same supplies to deal with blisters as you can for scrapes and minor cuts.
To deal with these problems you’ll want:
- Sterilize gauze pads
- Sterile gauze wraps
- Antiseptic ointment
- Antiseptic wipes
- 1” medical tape
- Mole foam
Unfortunately, burns make up a good number of critical backcountry injuries.
Dealing with them is difficult and requires training, as burns can quickly turn nasty. Large burns are also very difficult to keep clean on the trail and are prone to secondary infection.
The best medicine for wilderness burn injuries is prevention. Make sure your cooking stove and hot water pot are on a stable surface and use a burner stand with a wide base of support so it won’t tip over.
Always operate a backpacking stove by squatting on the balls of your feet and never sit near the stove.
If your stove spills boiling water you won’t have enough reaction time to get out of the way in a seated position. You’ll end up with a lapful of boiling water particularly if you’re cooking on a picnic table.
How to Treat Foot Problems on the Trail
Blisters are the most common injury you’re likely to encounter, I think it’s sensible to understand how to treat them.
Here’s an in-depth guide to teach you how to treat hot spots, so I won’t go in depth there.
When it comes to lancing (popping) blisters the jury is divided. I recommend people not lance blisters unless the size is causing problems. An intact-blister is generally quite sterile and infection-resistant.
At some point, the blister will pop, or you’ll choose to lance it.
Lancing it at a predetermined time has the advantage of giving you time to sterilize before and after to minimize infection risks.
When this happens you’ll want to:
- Wash your hands.
- Clean the area on and around the blister with a disinfectant wipe and/or soap and water.
Gently press the fluid out of the blister with a sterile instrument.
- Apply antibiotic ointment to the blister and around the site.
- Cover the blister site with sterile gauze lightly dressed with antibiotic ointment.
- Tape the gauze in place.
- Clean and re-dress no less than twice per day.
There are many variations and alterations to this process you can make with some knowledge and education.
If the blister site continues to be irritated you may get another blister deeper in the skin in the same spot.
Without treatment, these “deep” blisters can be dangerous and hard to treat – consider getting off the trail for a while.
Treating Other Trail Injuries
For athletic injuries such as sprains and strains the old RICE acronym still applies.
RICE stands for:
- Rest – Get off the injury and stop making it worse
- Ice – Use cold compresses to reduce swelling. Dunk a bandana in the creek to get cold water if you don’t have ice.
- Compression – Use an athletic wrap or bandage to wrap the site.
- Elevation – Lay on your back and put your foot up on a log or your backpack, above your heart.
For minor cuts, scrapes, and abrasions keeping them clean is usually enough.
- Clean with soap and water to thoroughly scrub out debris.
- Keep the area around the site sterile by covering with a gauze dressing
- Expose, clean, and redress the site multiple times per day.
It is beyond the scope of this article to teach you emergency life-saving procedures. These guidelines are not intended to replace medical training and are not comprehensive!
Self Care, Cleanliness, and Hygiene
One of the easiest ways to avoid NVD illnesses, and other trail problems, is to prevent them in the first place.
- Wash your hands after using the “facilities” with either hand sanitizer or environmentally-friendly soap & water.
- Wash your hands before eating anything
- Never let others reach into your bags of food, such as GORP. Instead, pour some out into their hands to prevent the spread of germs.
- Beware of shaking hands with other hikers. Germs travel fast on the trail and can have dire consequences, remember the norovirus outbreak on the Appalachian Trail in 2013 – 2015.
- Thoroughly wash dishes after use, and dispose of waste properly by following LNT guidelines. Dirty dishes are a major cause of NVD illness, and can attract bears.
- Carry hand sanitizer – keep it accessible, share with others when possible.
On top of all that, being on trail doesn’t give you a free pass to become a vector of disease. Please don’t take pride in being the filthiest hiker around – wash yourself! Keeping clean prevents many illnesses.
Survival Kit vs First Aid Kits
Survival and prepping are popular today, and as hikers, we’re all interested in these skills. Survival skills aren’t separate from medical skills, I think they complement one another.
A word of warning though: before taking survival advice from a medical pro, or medical advice from a survival expert – find out their level of training. Many survival hobbyists are not trained in wilderness medicine, and many medics aren’t necessarily the best survival resources.
I treat survival kits and first aid kits as separate topics. Sure, some items from a first aid kit may be helpful for survival, but they are not there for survival use.
Create, maintain, and treat your first aid kit as a medical response tool. In the same way, treat your survival kit as a survival tool – though some items in it may also be useful in wilderness medical applications.
Building the Perfect Hiking First Aid Kit
What should a good first aid kit have?
No matter how hard you try you’ll never get the perfect first aid kit. It just won’t happen. Instead what you should aim to do is be prepared to deal with ‘ordinary’ medical situations.
Focusing on highly improbable events is a problem that plagues hikers, preppers, and survivalists.
Sure, it is theoretically possible that you could be attacked by a bear, struck by lightning, and contract pneumonia at the same time. However, there are many more likely scenarios which should form the basis of our training and resources in the field.
Useful first aid kit contents include:
- Safety Pins
- Notepad and pen
- ACE wrap
- CPR mask
- 2nd Skin
- Antiseptic wipes
- Mole Foam
- Antibiotic Ointment
- Roller Gauze
- Med Tape
- SAM Splint
- Nitrile gloves
- Irrigation Syringe
- Butterfly sutures
- Triangle Bandages
In addition to these, you’ll include any number of personal preference items. This list is not comprehensive and is not meant to be able to handle all emergency medical situations.
It is simply covering many of the likely illnesses and injuries you may encounter.
These supplies are as good as useless if you have not had proper training in identifying and treating wilderness injuries and illnesses.
Medical Kits for different situations
It goes without saying that your first aid kit must be tailored to you, your situation, and the medical tasks you might encounter.
If you’re in Alaska in December you don’t need as much focus on treating stinging, biting, or burrowing insects. Conversely, hiking in Georgia in mid-summer you won’t need as many cold injury treatment supplies.
To keep your first aid kit from becoming unwieldy, you’ll need to tailor it for the season, location, and situation.
- Personal medications
- Number of people in your hiking group
- Treatments for recurring or chronic injuries
- Treatments for your hiking partners (including dogs)
- Age-based considerations for older or younger hikers
- Tools and medications for altitude illnesses at elevations over 8,judgment/li>
These are all examples of situational medical supplies you may want to consider. This list is not meant to replace your judgment from proper wilderness medicine training.
Knowing When to Call for Help
One of the most important judgment calls you can make is knowing when to make a call. Whether you’re using a PLB, cell phone, or smoke signals, you need to know when to call for backup.
Today’s wilderness SAR teams are extremely well-trained experts, but they all have families, and coming in to rescue you puts their lives at risk, too. So, how do you know when to make that call?
Generally, you should only use a PLB or rescue distress signal when life or limb is at risk.
In these situations, you may call for rescue knowing full well that it’s time for backup.
When is it not time to call for an evacuation? When you’re scared of the dark. When you’re beginning to feel mildly ill. When you’re wet, cold, lonely, tired and upset (but your life is not in danger).
SAR teams are not a shuttle service, but every year new and experienced hikers alike abuse the services provided by SAR teams around the world. Don’t be afraid to call for rescue if you are in peril, but remember the SAR helicopter team is putting themselves at risk by coming out looking for you.
That said, if you have cell service you can call 911. You can communicate with them where you are, what’s happening, how critical it is, and how best to work together to solve the problem.
Make no mistake, calling 911 may still launch a full-scale rescue operation – but sometimes it’s as simple as having the local Sheriff’s office bring an ATV a mile up the trail to help you out safely.
How do I know if I need ____ item in my first aid kit?
Frankly, the best way to know this is to go get trained. It costs very little to get a WFA certification and you’ll know a lot more when you walk out.
If you don’t have wilderness medicine training, then treat your first aid kit as a hikers injury box, with the common items you use at home. Things like tourniquets, triangle bandages, and advanced medical items are not much good if you don’t know how to use them.
Stick with what you know, and make sure you’re prepared to treat colds, common illnesses, and minor cuts scrapes and bruises. These are all things you’re already used to treating at home.
Where do I get my wilderness medicine training?
They’re widely regarded as the industry standard. Many guiding companies won’t accept certifications from other schools for their guides.
What do I do if I can’t handle an emergency myself?
Be prepared to signal for rescue in any high-risk remote environment with a PLB. Personal locator beacons are not toys, and they must be registered with the Coast Guard before use.
Once activated, a PLB sends out a signal (by various methods) that launches a rescue operation from the nearest SAR base. Once you hit that PLB button it’s all systems go!
Just remember they’re only to be used in dire emergencies.
Did this article teach me everything I need to know to stay safe in the wilderness?
No. This article is not formal training. This is not a comprehensive approach to wilderness first aid kits by any means.
Nothing replaces appropriate training by a wilderness medicine professional.
Advice in this article is meant to supplement training and certification. It’s not trying to define scope of practice, standing orders, or medical protocol in any way.
There’s a lot to know about wilderness medicine and that in turn affects the type, size and scope of your first aid kit. If in doubt, stick with what you know. Extra fancy gadgets are only as good as the user’s training.
If you’re just getting started we’ve outlined the first aid kits that help you get going quickly. Remember to go through them and make sure you can identify, and know how to use, each item in your med kit.
Once you know, research, learn, train with, and master the contents of your first aid kit your confidence and safety on future hiking trips will skyrocket!
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